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O'Neil LM, O'Neill M, Whelan F, Leahy T, Wormald R, Hinton-Bayre AD, Ghandour J, Kuthubutheen J. Novel ENT live telehealth and live video-otoscopy clinics in remote Australia: outcomes and comparisons to traditional clinic models. J Laryngol Otol 2024; 138:253-257. [PMID: 37698117 DOI: 10.1017/s0022215123001561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/13/2023]
Abstract
BACKGROUND Coronavirus disease 2019 challenged the delivery of healthcare in Australia, disproportionately impacting vulnerable patients, including Aboriginal and/or Torres Strait Islander peoples and those living in remote regions. The otolaryngology service provided to remote Western Australia adapted to these barriers by altering clinical consultations to a digital model. METHODS A review was undertaken of patients in regional Western Australia. Demographics and clinical outcomes from 20 live telehealth clinics were retrospectively reviewed and compared to 16 face-to-face clinics. RESULTS The demographics of patients reviewed in both live telehealth and face-to-face clinics were similar, except for a larger proportion of Aboriginal and/or Torres Strait Islander patients utilising telehealth. The outcomes of patients reviewed through each model of care were comparable. Live video-otoscopy provided diagnostic quality images in 92 per cent of cases. CONCLUSION The findings of our review suggest that, despite its limitations, a large proportion of ENT patients may be safely assessed through a live telehealth model.
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Affiliation(s)
- Luke M O'Neil
- Western Australian Country Health Service, Perth, Australia
- Division of Surgery, Medical School, University of Western Australia, Perth, Australia
| | - Margie O'Neill
- Western Australian Country Health Service, Perth, Australia
| | - Fiona Whelan
- Western Australian Country Health Service, Perth, Australia
| | - Travis Leahy
- Western Australian Country Health Service, Perth, Australia
- Division of Otolaryngology, Medical School, The University of Notre Dame, Perth, Australia
| | - Robert Wormald
- Western Australian Country Health Service, Perth, Australia
| | - Anton D Hinton-Bayre
- Western Australian Country Health Service, Perth, Australia
- Division of Surgery, Medical School, University of Western Australia, Perth, Australia
| | | | - Jafri Kuthubutheen
- Western Australian Country Health Service, Perth, Australia
- Division of Surgery, Medical School, University of Western Australia, Perth, Australia
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Habib AR, Crossland G, Patel H, Wong E, Kong K, Gunasekera H, Richards B, Caffery L, Perry C, Sacks R, Kumar A, Singh N. An Artificial Intelligence Computer-vision Algorithm to Triage Otoscopic Images From Australian Aboriginal and Torres Strait Islander Children. Otol Neurotol 2022; 43:481-488. [PMID: 35239622 DOI: 10.1097/mao.0000000000003484] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To develop an artificial intelligence image classification algorithm to triage otoscopic images from rural and remote Australian Aboriginal and Torres Strait Islander children. STUDY DESIGN Retrospective observational study. SETTING Tertiary referral center. PATIENTS Rural and remote Aboriginal and Torres Strait Islander children who underwent tele-otology ear health screening in the Northern Territory, Australia between 2010 and 2018. INTERVENTIONS Otoscopic images were labeled by otolaryngologists to classify the ground truth. Deep and transfer learning methods were used to develop an image classification algorithm. MAIN OUTCOME MEASURES Accuracy, sensitivity, specificity, positive predictive value, negative predictive value, area under the curve (AUC) of the resultant algorithm compared with the ground truth. RESULTS Six thousand five hundred twenty seven images were used (5927 images for training and 600 for testing). The algorithm achieved an accuracy of 99.3% for acute otitis media, 96.3% for chronic otitis media, 77.8% for otitis media with effusion (OME), and 98.2% to classify wax/obstructed canal. To differentiate between multiple diagnoses, the algorithm achieved 74.4 to 92.8% accuracy and an AUC of 0.963 to 0.997. The most common incorrect classification pattern was OME misclassified as normal tympanic membranes. CONCLUSIONS The paucity of access to tertiary otolaryngology care for rural and remote Aboriginal and Torres Strait Islander communities may contribute to an under-identification of ear disease. Computer vision image classification algorithms can accurately classify ear disease from otoscopic images of Indigenous Australian children. In the future, a validated algorithm may integrate with existing telemedicine initiatives to support effective triage and facilitate early treatment and referral.
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Affiliation(s)
- Al-Rahim Habib
- Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia
- Department of Otolaryngology-Head and Neck Surgery, Princess Alexandra Hospital, Brisbane, Queensland, Australia
- Department of Otolaryngology - Head and Neck Surgery, Westmead Hospital, Sydney, New South Wales, Australia
| | - Graeme Crossland
- Department of Otolaryngology - Head and Neck Surgery, Royal Darwin Hospital, Darwin, Northern Territory, Australia
| | - Hemi Patel
- Department of Otolaryngology - Head and Neck Surgery, Royal Darwin Hospital, Darwin, Northern Territory, Australia
| | - Eugene Wong
- Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia
- Department of Otolaryngology - Head and Neck Surgery, Westmead Hospital, Sydney, New South Wales, Australia
| | - Kelvin Kong
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
- Department of Linguistics, Faculty of Medicine, Macquarie University, Sydney, New South Wales, Australia
- School of Population Health, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Hasantha Gunasekera
- Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia
- The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Brent Richards
- Division of Medical Services, Gold Coast University Hospital, Gold Coast, Queensland, Australia
- Griffith Health, Griffith University Queensland, Australia
| | - Liam Caffery
- Centre for Online Health, University of Queensland, Australia
| | - Chris Perry
- Centre for Online Health, University of Queensland, Australia
| | - Raymond Sacks
- Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia
| | - Ashnil Kumar
- School of Biomedical Engineering, Faculty of Engineering, University of Sydney, Camperdown, New South Wales, Australia
| | - Narinder Singh
- Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia
- Department of Otolaryngology - Head and Neck Surgery, Westmead Hospital, Sydney, New South Wales, Australia
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Children with Secondary Care Episodes for Otitis Media Have Poor Literacy and Numeracy Outcomes: A Data Linkage Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010822. [PMID: 34682568 PMCID: PMC8535982 DOI: 10.3390/ijerph182010822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 10/08/2021] [Accepted: 10/12/2021] [Indexed: 11/17/2022]
Abstract
We examined the association between otitis media (OM) and educational attainment in a retrospective population cohort of Western Australian children who participated in the grade 3 National Assessment Program—Literacy and Numeracy in 2012 (N = 19,262). Literacy and numeracy scores were linked to administrative hospital and emergency department data to identify secondary care episodes for OM. Results of multivariate multilevel models showed that children with OM episodes had increased odds of poor performance on literacy and numeracy tests, compared to children without OM episodes (46–79% increase in odds for Aboriginal children; 20–31% increase in odds for non-Aboriginal children). There were no significant effects found for age at the first episode, nor for OM episode frequency (all ps > 0.05). Regardless of the timing or frequency of episodes, children with OM episodes are at risk of poor literacy and numeracy attainment. Aboriginal children with OM appeared to be particularly at risk of poor literacy and numeracy achievement. Intervention to reduce the prevalence of otitis media in young children, and early treatment of OM, are important for limiting the negative effects on academic outcomes.
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McMahon CM, Nieman CL, Thorne PR, Emmett SD, Bhutta MF. The inaugural World Report on Hearing: From barriers to a platform for change. Clin Otolaryngol 2021; 46:459-463. [PMID: 33733605 DOI: 10.1111/coa.13756] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 03/07/2021] [Indexed: 12/20/2022]
Abstract
The inaugural World Report on Hearing was recently published by the World Health Organisation, and outlines the burden of hearing loss, and strategies to overcome this through preventative and public health approaches. Here, we identify barriers to wide-scale adoption, including historic low prioritisation of hearing loss against other public health needs, a lack of a health workforce with relevant training, poor access to assistive technology, and individual and community-level stigma and misunderstanding. Overcoming these barriers will require multi-sector stakeholder collaboration, involving ear and hearing care professionals, patients, communities, industry and policymakers.
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Affiliation(s)
- Catherine M McMahon
- HEAR Centre, Macquarie University, Sydney, NSW, Australia.,Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Carrie L Nieman
- Department of Otolaryngology-Head & Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Cochlear Center for Hearing & Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Peter R Thorne
- Section of Audiology, University of Auckland, Auckland, New Zealand.,Eisdell Moore Centre, University of Auckland, Auckland, New Zealand
| | - Susan D Emmett
- Department of Head and Neck Surgery and Communication Sciences, Duke University School of Medicine, Durham, NC, USA.,Duke Global Health Institute, Durham, NC, USA
| | - Mahmood F Bhutta
- University Hospitals Sussex, Brighton, UK.,Brighton & Sussex Medical School, Brighton, UK
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